You are wrong!

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When news like this circulates, it is mandatory that the medical community should react.

Whatever the president insists, he is totally wrong on this matter.

Fentanyl is a potent synthetic opioid.

It is 100 times more potent than morphine as an analgesic. (Yes, Mr. President.  It is a painkiller.  A very very very strong pain killer.)

Its pharmacologic effects are – analgesia, sedation, nausea, vomiting, itching and respiratory depression. Compared to other opioids, fentanyl causes more muscle rigidity.

It’s approved medical uses (licit) are:

  • management of cancer pain in patients already receiving opioid medication for their underlying persistent pain  (for the sublingual tablet formulations)
  • management of chronic pain in patients who require continuous opioid analgesia (for the transdermal preparation)
  • analgesia and anaesthesia in surgery (as citrate for injections given intravenously, intramuscularly, spinally or epidurally)

It is abused (illicit) for the following effects:

  • euphoria
  • substitute for heroin in opioid dependent individuals

Whether it is used licitly or illicitly, fentanyl use is addicting. Drugs that cause dependence are classified as habit forming and categorised as dangerous drugs. Under the DEA (drug enforcement agency of the United States), Fentanyl is controlled under Schedule II of the Controlled Substances Act.

A drug under Schedule II of the Controlled Substances Act means that:

  • The drug has a high potential for abuse.
  • The drug has a currently accepted medical use in treatment in the US or a currently accepted medical use with severe restrictions.
  • Abuse of the drug may lead to severe psychological or physical dependence.

In the Philippines, the Dangerous Drug Board and Philippines Drug Enforcement Agency have rules on prescribing narcotics and regulated substances.  The schedule in the Philippines is similar to the United States. Fentanyl is classified under Level II (previously called Schedule II). While it carries the same classifying definition as the US DEA, in addition:

  • Only doctors with S2 licences can prescribe them.  (Not all doctors have a S2 license.)
  • There is a separate yellow prescription form (that can only be purchased through the selected hospitals by S2 licensed physicians) that needs to be accomplished.  Fentanyl falls under that category.

Fentanyl is a controlled substance. In any part of the world. And yes. Even in China and Russia.

It is not JUST a pain killer.

It is addicting. It is regulated. Controlled substances are classified as with medical evidence or without. Either ways, it has abuse potentials. Only schedule or level II drugs are “legally” allowed to be prescribed. But it does not mean that just because it is prescribed it is not addicting.

I really don’t care if you’re using this for the various pains you claim to have. I’m really not concerned whether you’re really sick or not, or how sick you are. I just don’t like the fact that you go around having to rationalize what medicines you use to the point of changing the science of medicine, pharmacology and regulatory science.

Just because you are president, you do not get to change the fact that fentanyl is an opiate.

Period.

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